{"id":"1b962f9e2aae","type":"article","url":"https://hartvaat.nl/2026/05/05/thuis-bio-impedantie-voor-hartfalen-haalbaar-en-acceptabel-klinische-winst-nog-n/","title":"Thuis-bio-impedantie voor hartfalen: haalbaar en acceptabel, klinische winst (nog) niet aangetoond","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["step-hfpef"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag106","source_url":"https://doi.org/10.1093/eschf/xvag106","authors":["Min Gyu Kong","Inki Moon","Jon Suh","Jah Yeon Choi","Jin Oh Na","Hwan-Seok Yong","Chi Young Shim","Seong-Mi Park","Eung Ju Kim"],"significance":5,"published":"2026-06-28","source_date":"2026-05-05","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/antiaritmica-farmacologie/","https://hartvaat.nl/kennis/hartfalen/hartfalen-stadiumindeling-nyha/"],"congress":"","summary_en":"Multicenter open-label randomised feasibility trial (n=40) in heart failure patients on loop diuretics, randomised to standard care or a home bioelectrical impedance analysis (BIA) device with a paired app providing weekly diuretic guidance. BIA-measurement adherence was 82.5%, completion 100%, and acceptability high (4.21/5 usability, 3.90/5 acceptability). No significant differences in NT-proBNP or oedema index between groups. NYHA worsening occurred less often in the BIA group (10% vs 31.6%; p=0.095). Changes in oedema index correlated more strongly with NT-proBNP (r=0.54) than changes in body weight (r=0.24). No HF hospitalisations or deaths during follow-up. Home BIA monitoring with pre-emptive diuretic management is feasible and safe, but larger trials are needed to demonstrate clinical effect.","created":"2026-07-03T10:33:07Z","updated":"2026-07-03T13:32:02Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Multicenter open-label gerandomiseerde haalbaarheidsstudie (n=40) bij hartfalenpatiënten op lisdiuretica, gerandomiseerd tussen standaardzorg en een thuis-bio-elektrische impedantie-analyse (BIA)-device met gekoppelde app die wekelijks diuretica-advies gaf. Adherentie aan de BIA-metingen was 82,5%, voltooiingsgraad 100%, en gebruikersacceptatie hoog (4,21/5 usability, 3,90/5 acceptability). Geen significante verschillen in NT-proBNP of oedeem-index tussen groepen. Verergering van NYHA-klasse trad iets minder vaak op in de BIA-groep (10% vs 31,6%; p=0,095). Veranderingen in oedeem-index correleerden sterker met NT-proBNP (r=0,54) dan veranderingen in gewicht (r=0,24). Geen HF-opnames of sterfte tijdens follow-up. Thuis-BIA-monitoring met preëmptief diureticabeleid is haalbaar en veilig, maar grotere studies zijn nodig voor klinisch effect.","abstract_original":"INTRODUCTION: This study evaluated the feasibility, acceptability, and clinical effectiveness of a home-based body water monitoring and pre-emptive management system using bioelectrical impedance analysis (BIA) in patients with heart failure (HF). METHODS: In this multicentre, open-label, randomized controlled trial, 40 HF patients receiving loop diuretics were assigned to standard care or a home BIA group using a home-based BIA device with a linked application providing weekly feedback and guidance on diuretic management. Feasibility outcomes included study completion, adherence, usability and acceptability scores, and adverse events over 12 weeks. Effectiveness outcomes included changes in NT-proBNP, oedema index, New York Heart Association (NYHA) functional class, HF hospitalization, and all-cause mortality. RESULTS: Thirty-nine patients were included in the final analysis after exclusion of one patient lost to follow-up in the control group. Patients in the control group were older than those in the home BIA group (70.4 ± 8.3 vs 57.2 ± 13.5; P = .003), and baseline NT-proBNP levels were higher (2737.1 ± 3817.1 vs 1357.7 ± 2196.8 pg/ml; P = .013), while other baseline characteristics were comparable. In the home BIA group, the completion rate was 100.0% and adherence to BIA measurements was 82.5%. Acute kidney injury occurred in one patient (5.0%), with no discontinuations due to adverse events. Usability and acceptability were high (4.21 ± 0.59; 3.90 ± 0.53, respectively) on a 5-point Likert scale. There were no significant differences in changes in NT-proBNP or oedema index during follow-up between groups. Worsening NYHA class occurred less frequently in the home BIA group (10.0% vs 31.6%; P = .095). Changes in the oedema index correlated with changes in NT-proBNP (r = 0.544; P = .002), whereas changes in body weight did not (r = 0.237; P = .147). No HF hospitalizations or deaths occurred. CONCLUSION: Home-based BIA monitoring with pre-emptive management is feasible, acceptable, and safe for patients with HF."}